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A new minimally invasive technique for the repair of diastasis recti: a pilot study

BACKGROUND: Diastasis recti is an abdominal wall defect that occurs frequently in women during pregnancy. Patients with diastasis can experience lower back pain, uro-gynecological symptoms, and discomfort at the level of the defect. Diastasis recti is diagnosed when the inter-rectus distance is >...

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Autores principales: Manetti, Gabriele, Lolli, Maria Giulia, Belloni, Elena, Nigri, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195785/
https://www.ncbi.nlm.nih.gov/pubmed/33661384
http://dx.doi.org/10.1007/s00464-021-08393-2
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author Manetti, Gabriele
Lolli, Maria Giulia
Belloni, Elena
Nigri, Giuseppe
author_facet Manetti, Gabriele
Lolli, Maria Giulia
Belloni, Elena
Nigri, Giuseppe
author_sort Manetti, Gabriele
collection PubMed
description BACKGROUND: Diastasis recti is an abdominal wall defect that occurs frequently in women during pregnancy. Patients with diastasis can experience lower back pain, uro-gynecological symptoms, and discomfort at the level of the defect. Diastasis recti is diagnosed when the inter-rectus distance is > 2 cm. Several techniques, including both minimally invasive and open access surgical treatment, are available. Abdominoplasty with plication of the anterior rectus sheath is the most commonly used, with the major limitation of requiring a wide skin incision. The new technique we propose is a modification of Costa’s technique that combines Rives–Stoppa principles and minimally invasive access using a surgical stapler to plicate the posterior sheaths of the recti abdominis. METHODS: It is a fully laparoscopic technique. The pneumoperitoneum is induced from a sovrapubic trocar, placed using an open access technique. The posterior rectus sheath is dissected from the rectus muscle using a blunt dissector to create a virtual cavity. The posterior sheets of the recti muscles are plicated using an endo-stapler. A mesh is then placed in the retromuscular space on top of the posterior sheet without any fixation. Using a clinical questionnaire, we analyzed the outcomes in 74 patients who underwent minimally invasive repair for diastasis of the rectus abdominis sheath. RESULTS: Seventy-four patients (9 men and 65 women) were treated using this technique. Follow-up was started two months after surgery. All procedures were conducted successfully. There were no major complications or readmissions. No postoperative infections were reported. There were two recurrences after six months. There was a significant reduction in symptoms. CONCLUSIONS: This new method is feasible and has achieved promising results, even though a longer follow-up is needed to objectively assess this technique. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00464-021-08393-2.
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spelling pubmed-81957852021-06-28 A new minimally invasive technique for the repair of diastasis recti: a pilot study Manetti, Gabriele Lolli, Maria Giulia Belloni, Elena Nigri, Giuseppe Surg Endosc Dynamic Manuscript BACKGROUND: Diastasis recti is an abdominal wall defect that occurs frequently in women during pregnancy. Patients with diastasis can experience lower back pain, uro-gynecological symptoms, and discomfort at the level of the defect. Diastasis recti is diagnosed when the inter-rectus distance is > 2 cm. Several techniques, including both minimally invasive and open access surgical treatment, are available. Abdominoplasty with plication of the anterior rectus sheath is the most commonly used, with the major limitation of requiring a wide skin incision. The new technique we propose is a modification of Costa’s technique that combines Rives–Stoppa principles and minimally invasive access using a surgical stapler to plicate the posterior sheaths of the recti abdominis. METHODS: It is a fully laparoscopic technique. The pneumoperitoneum is induced from a sovrapubic trocar, placed using an open access technique. The posterior rectus sheath is dissected from the rectus muscle using a blunt dissector to create a virtual cavity. The posterior sheets of the recti muscles are plicated using an endo-stapler. A mesh is then placed in the retromuscular space on top of the posterior sheet without any fixation. Using a clinical questionnaire, we analyzed the outcomes in 74 patients who underwent minimally invasive repair for diastasis of the rectus abdominis sheath. RESULTS: Seventy-four patients (9 men and 65 women) were treated using this technique. Follow-up was started two months after surgery. All procedures were conducted successfully. There were no major complications or readmissions. No postoperative infections were reported. There were two recurrences after six months. There was a significant reduction in symptoms. CONCLUSIONS: This new method is feasible and has achieved promising results, even though a longer follow-up is needed to objectively assess this technique. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00464-021-08393-2. Springer US 2021-03-04 2021 /pmc/articles/PMC8195785/ /pubmed/33661384 http://dx.doi.org/10.1007/s00464-021-08393-2 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Dynamic Manuscript
Manetti, Gabriele
Lolli, Maria Giulia
Belloni, Elena
Nigri, Giuseppe
A new minimally invasive technique for the repair of diastasis recti: a pilot study
title A new minimally invasive technique for the repair of diastasis recti: a pilot study
title_full A new minimally invasive technique for the repair of diastasis recti: a pilot study
title_fullStr A new minimally invasive technique for the repair of diastasis recti: a pilot study
title_full_unstemmed A new minimally invasive technique for the repair of diastasis recti: a pilot study
title_short A new minimally invasive technique for the repair of diastasis recti: a pilot study
title_sort new minimally invasive technique for the repair of diastasis recti: a pilot study
topic Dynamic Manuscript
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195785/
https://www.ncbi.nlm.nih.gov/pubmed/33661384
http://dx.doi.org/10.1007/s00464-021-08393-2
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